Muhammad Ayoub Laghari, Asadullah Makhdoom, Muhammad Khan Pahore, Riaz Ahmed Raja, Irshad Ahmed Bhutto.
Amputation in diabetic foot.
Med Channel Jan ;17(1):60-4.

Objective: To assess the frequency of amputation in diabetic foot with morbidity and mortality. Methods: The study was carried out at the department of Orthopaedic Surgery and traumatology Unit -1, Liaquat University of Medical and Health Sciences Jamshoro from July 2007 to June 2008. The study design was prospective. All type II diabetes patients having foot complications were included and patients with type I diabetes were excluded from the study. All the patients were assessed by the Wagner’s grading system of diabetic foot and the most common grade of diabetic foot in this study were grade II and III. Operative procedures were, wound debridement, incision and drainage, small and big toe amputation, below and above knee amputation. Results: Total number of patients was 58; there were 39(67.24%) male and 19(32.75%) female patients with male female ratio of 3:1. Age ranged between 30 to 70 years with average age 52 years. Wound debridement was done in 14(24.15%) patients, below knee amputation 12(20.69%), above knee amputation 09(15.52%), small toe amputation 11(18.96%), big toe amputation in 07(12.06%) and incision and drainage in 5(8.62%) patients. Overall amputation rate in the study was 39(67.24%) patients with minor amputations in 18(31.4 %) patients and 21(36.20 %) major limb amputation. Mortality rate in this study was 08(13.7 %). Mild Phantom pain was reported by 53%. Conclusion: We conclude that diabetic foot is leading cause of amputations resulting in high morbidity and mortality. These complications can be prevented by early detection, adequate glycemic control and timely referral of diabetic foot patients to specialists. Patient’s education and training to general practitioners at district level about foot care are the most important measure to curtail disabilities resulting from diabetic foot

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